Frailty Care Coordinator

The Frailty Care Coordinator will work closely with the GPs and other primary care professionals to identify and manage a caseload of identified patients, making sure that appropriate support is made available to them and their carers, and ensuring that their changing needs are addressed. They focus delivery of the comprehensive model to reflect local priorities, health inequalities or population health management risk stratification. They will be the first point of call for this identified cohort, proactively managing their needs, and coordinating the Multidisciplinary Team to meet them. They will provide holistic and person-centred care and support for people of all ages but with a particular focus on the care of older people/long term conditions and those living with Frailty as per the practice demographic. This role will assist practice staff in the provision of treatment, preventative care, health promotion and patient education. In addition, the successful candidate will be expected
to support the administrative team. The role includes supporting digital initiatives and co-ordinating the patients journey through the health and social care system. The candidate will need to be an excellent communicator and be able to establish efficient monitoring and quality assurance systems.